• Journal of Chest Surgery
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• v.21 no.3
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• pp.558-562
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• 1988

Localized mesothelioma is a primary pleural tumor that induces hypoglycemia rarely. We experienced a case of the localized mesothelioma that induced hypoglycemia. The patient was 70 year-old man who was admitted to Severance Hospital because of general weakness and mental confusion in morning before breakfast. He was found to have low level of fasting blood sugar and C-peptide, but had normal serum insulin level. After excision of the tumor, the patient was free from symptoms of hypoglycemia, and fasting blood sugar level was returned to normal range. The most likely speculation of causing hypoglycemia by the mesothelioma was thought to be that the tumor did not secrete insulin itself but the undetectable insulin-like substance and/or antigluconeogenic substances. During the follow up, 5 months after surgical removal of tumor, the patient was in a good condition without symptoms of hypoglycemia.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.194-197
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• 1999

We experienced an extremely rare case of lipoid pneumonia combined with empyema. A 53-year-old patient was admitted because of chilling sensation and blood tinged sputum. Simple X-ray and computered tomography(CT) showed a huge homogeneous opacification in the left lower lung field. This patient was diagnosed as endogenous type lipoid pneumonia by a computed tomography guided needle biopsy; decortication and left lower lobectomy are performed. We diagnosed it as endogenous type lipoid pneumonia because it revealed a foreign body reaction and lipid laden macrophage on the pathologic examination.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.593-597
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• 1992

The bronchopleural fistula[BPF] due to bronchial stump disruption after pneumonec-tomy has remained one of the most dreadful complications to now. The management of the BPF with empyema thoracis are still therapeutic dilemma even though a various surgical methods for the control of BPF with or without empyema thoracis. We have experienced the successful treatment of BPF & empyema thoracis with transsternal transpericardial approach. The patient was a 54 years old male who was taken left pneumonectomy at W. Medical Center at sept, 19th. 1991. He was suffered from the BPF R empyema thoracis and so was transferred to our hospital at Nov. 19th. 1991. We treated the patient with transsternal transpericardial bronchial closure for BPF, and put clagett procedure for empyema thoracis in 2 weeks. We think this kind of surgical techniques is one of the relatively simple and effective method for the control of BPF and empyema thoracis.

• Journal of Chest Surgery
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• v.34 no.1
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• pp.97-100
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• 2001

흉막의 고립성 섬유성 종양은 중피하에 존재하는 미분화 중배엽성 기원의 섬유 세포에서 기원하는 종양으로 알려졌다. 이 종양은 대부분 양성으로 보고되고 있으나 병리학적으로 높은 세포 밀도, 유사분열의 수가 많고(10개의 고배율 시야에서 4개 이상), 핵의 다양성, 출혈, 괴사등이 있으며 악성의 판단기준으로 보고된다. 환자는 62세 여자로 호흡곤란 및 기침을 주소로 본원에 입원하였으며 단순 흉부 방사선 및 전산화 단층 촬영상 우측 흉강내에 거대한 종양소견이 보였다. 이 종양은 23$\times$18$\times$12 cm, 2 kg의 크기와 무게를 가졌으며 우측폐 하엽과 중엽은 압박되어있었으나 종양 절개 후 재 팽창됨을 확인하였다. 또한 횡경막과 심하게 유착되어 박리도중 손상이 동반되어 봉합술이 필요하였다. 병리학적으로 종괴는 세포밀도가 높았고 방추형세포의 다발로 이루어져 있었으며 유사분열의 수가 많이(27 mitosis/10HPF)보였다. 면역 조직 화학 검사상 vimentin과 CD34에 양성 반응을 보였다. 이에 악성 고립성 섬유성 종양으로 확진되었다. 본 교실에서는 흉막에 발생한 악성 고립성 섬유성 종양을 치험하였기에 문헌 고찰과 함께 보고한다.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.10-15
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• 1989

Excision of bullous emphysema or decortication of chronic empyema commonly results in a prolonged air leakage. Prolonged air leakage requires prolonged intercostal drainage, delays recovery, and can be followed complications such as pneumothorax, atelectasis, incomplete expansion of remained lung, secondary infection. To minimize these complications free muscle grafts can be used like a patch to close the opening of visceral pleura and reinforce suture lines without undue tension. From a preliminary study using the latissimus dorsi muscle as a free muscle graft in the rabbit pleural space, viable muscle fibers that seems the result of the process of regeneration can be consistently identified around the degenerating muscle fibers. Voluminous connective tissues and numerous blood vessels are also observed in the peripheral zone. Further studies in that free muscle graft will be sutured with visceral pleura and lung parenchyme will hopefully provide additional information before clinical application.

• Journal of Chest Surgery
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• v.33 no.6
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• pp.525-527
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• 2000

Subarachnoid-pleural fistula after routine thoracotomy is a rare complication but a very serious problem. Twenty one cases have been reported in the literature. We report a care of subarchnoid-pleural fistula that dveloped after the esecation of posterior mediastinal neurogenic tumor. The patient presented with large amount of clear pleural fluid with mild headache and dizziness. Surgical intervention following a trial of conservative therapy was undertaken because we strongly suspected subarachnoid-pleural fistula. A dural tear was found at the level of resected intercostal nerve root. The dura was closed by way of direct suture and fibrin glue. In this case, the recognition of subarachnoid-pleural fistula formation is difficult because the patient had not presented any neurologic deficit.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1677-1681
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• 2000

Microsurgical transthoracic extrapleural approach for thoracic discectomy in three cases were modified and simplified in order to achieve better exposure of ventral extradural space than posterolateral extrapleural(lateral extracavitary) approach and less pulmonary complications than transthoracic transpleural approach. These approaches were optimized by microscope and video-assistance. Surgery was followed by clinical improvement in all patients. The results of treatment seem to support the use of these modified techniques as adequate surgical treatment of thoracic disc herniations without any complications.

• Journal of Chest Surgery
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• v.36 no.2
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• pp.98-100
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• 2003

Recently, Minimally invasive direct coronary artery bypass surgery (MIDCAB) is becoming one of the rapidly developing strategies in cardiac surgery. We report a case of MIDCAB used in upper sternotomy because of severe pleural adhesion.

• Journal of Chest Surgery
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• v.26 no.7
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• pp.538-542
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• 1993

An approach to the treatment of post-operative pain by the injection of bupivacaine into the pleural space through an intrapleural cathter has been studied. Among 24 thoracotomy patients, bupivacaine was injected only to experimental group[ 12 patients ] when the patient was able to head up for oneself during recovery from anesthesia. The pain and ROM[ range of motion ] scores, respiration rate, PaCO2 level of both experimental and control group were measured at the time of head-up and 30 and 120 minutes thereafter.The scores of pain and ROM of experimental group were significantly[ P value < 0.05 ] decreased in 30 minutes and 120 minutes after bupivacaine injection compared with those of control group but respiration rate and PaCO2 level were not changed significantly. With this result, we can suggest that intrapleural injection of bupivacaine is useful for pain relief following thoracotomy.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.1039-1043
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• 1991

The bullectomy, or sedge resection of the lung including bullae is the treatment of choice for the recurrent spontaneous pneumothorax, and but results in pleuropulmonary fistulae in postoperative periods in some emphysematous lungs. There are many methods to close the air leakages with T-M, Talc powders. Or the closure of air leakage sites can be closed c resuture, wedge resection or lobectomy through re-explothoracotomy. Tisseel, a in thoracic surgical areas in recents. We have sealed the post-operative air leakage sites after bullectomy or segmental resection for 4 recurrent spontaneous pneumothorax with the spray of Tisseel & throbin through thoracoscope without re-explothoracotomy. The post-operative courses are uneventful to now.